Keeping silent about sex and limiting people’s ability to express sexuality can lead to a greater risk of HIV/Aids infection.

That’s one of the arguments Shereen El Feki makes in her latest book “Sex and the Citadel” after five years of researching the conservative approach to sex and relationships Islamic Middle Eastern countries take.

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“In today's Arab world, the only socially-accepted context for sex is heterosexual, family-sanctioned, religiously-approved, state-registered marriage—a social citadel,” wrote El Feki in an article for CNN earlier this year.

In the same post, she wrote one of the consequences of such a strict view of sexual expression is the rising rate of people infected with HIV and sexually-transmitted diseases.

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The Middle East “is one of two parts in the world where HIV is still on the rise,” El Feki said in an interview with DNA.

The Guardian reports HIV infections rates have nearly doubled since 2001 in the Middle East and North Africa.

In Islamic society, she says, young people have been engaging in risky behavior which mostly includes having sex with multiple partners, same-sex partners, and sex workers, all without a condom.

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One study she cites shows that out of 400 female sex workers surveyed in Syria, only about 13 percent said they consistently used condoms with their clients. In Yemen, only 35 percent of 300 women reported using a condom with their most recent client.

El Feki points out that many sex workers believe they can keep their virginity intact and not be at risk of HIV/Aids because they only perform anal and oral sex, which isn’t true. She told DNA that many of these male clients are the same men who end up marrying women who are pressured to remain virgins until marriage.

As far as same-sex relations, out of 1,000 men surveyed in Tunisia, only about 29 percent admitted to using a condom during their most recent act of intercourse. And up to 92 percent of 791 men in Egypt had commercial sex within the last six months of being surveyed.

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In the end, El Feki says all of this holds back young Arab people from having healthy sexual committed relationships.

“Arabic used to once be a language of sex,” she said. But, “there’s so little sexual education in schools that people don’t know that there is another arabic in which you could talk about these matters.”

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Ironically, El Feki said the solution to reverse the public health issues occurring in the Middle East today lies in the roots of Islam.

“There’s nothing in ‘The Joy of Sex,’ ‘YouPorn,’ or indeed ‘Fifty Shades of Grey’’ that the Arabs were not writing about,” El Feki said, adding that religious scholars wrote plenty about sex. “They found there is nothing incompatible between the needs of the flesh and the needs of the faith.”